[Question #1222] Received Oral Sex from Gay Man - Very Nervous

49 months ago

I am a 50 yo male, and I received deep oral sex and kissing from a gay male Thursday night – almost 3 days ago.  I am married 15+ years and don't know how this happened (even after several drinks).  I am now very anxious and cannot even think straight.  The guy told me he tested HIV- 2 weeks ago, but I am worried about all the other issues like syphilis, gonorrhea, NGU, HSV-1, HPV, etc.  I had canker sores on my tongue when I was younger, but no cold sores.  So, until now I don't believe I have had HSV-1.

1) Can I anonymously go to an STD clinic to get pills now to take care of anything (e.g., syphilis, etc)?  2) Are there any direct questions I can ask the guy (e.g., did you have any sores in your mouth) that would help?  But, I'm not sure if I will get straight answers.  I didn't see any noticeable sores on his mouth.  3) If no symptoms appear on me, when can I safely have vaginal and oral sex (cunnilingus and fellatio) again with my wife? 4) What are your expert recommendations?

I have read other posts stating HPV transmission from mouth to penis is rare.  Is that true?  I am worried it will show up on a future pap smear of my wife.

I am very anxious and can't sleep.

Thank you


Edward W. Hook M.D.
Edward W. Hook M.D.
49 months ago

Welcome to our Forum. I'll provide some information which I hope will help you.  The exposure you describe was low risk for all STIs.  No STIs are transmitted through kissing, even deep kissing and few STIs are acquired as a result of receipt of fellatio.  HIV is not transmitted in this way, and as you note, HPV is quite rare,  and unless there were OBVIOUS oral sores (you would have noticed while kissing), syphilis is not a concern.  So, what is left- gonorrhea is sometimes acquired as a result of receipt of oral sex, as is non-gonococcal urethritis.  If you do not already have HSV-1 (the fact that you are not aware of cold sores does not mean that you do not already have HSV-1- about 2/3 of persons with HSV-1 have no recollection of cold sores), there about a 1 in 1000 chance that you got HSV-1 from receipt of oral sex.   

If you do not develop obvious penile discharge or burning on urination in the next 2-3 days (i.e. about 5 days after your exposure), you most likely did not get gonorrhea or NGU.  Herpes can take up to two weeks to show up after acquisition.  For most people , the absence of symptoms within the time frame you have described is sufficient to comfort them and no testing is needed.  If you wish for the comfort of negative tests, you could go to your doctor or an STD Clinic and get tested for gonorrhea and NGU.  We DO NOT recommend taking antibiotics "just in case" and would recommend against any blood tests for HSV- they are often falsely positive and misleading. 

Were I you, if there are no symptoms by mid-week to indicate a need for testing, I would be comfortable that I had not acquired anything. At that time I would also be comfortable having unprotected se without fear of giving my partner an STI acquired in the dalliance you describe. 

I hope these comments are helpful in addressing your concerns and anxiety.  The chance that you acquired anything from this event is quite low.  EWH

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49 months ago

Thank you very much for the very prompt response on a Sunday night--it is much appreciated.  You have calmed my nerves.  At this point, I will take a wait and see approach for at least the next several days.

Edward W. Hook M.D.
Edward W. Hook M.D.
49 months ago
That is precisely that approach I would recommend and endorse.  I am confident you will be fine.  EWH
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48 months ago

It's been 8 days after the encounter without any symptoms.  Coincidentally, because of an unrelated sinus infection (which started even before the encounter), 2 days ago I was prescribed doxycycline 100 mg twice a day for 10 days.  I have read doxycycline can help against any gonorrhea, NGU and syphilis exposure I may have had.  But, I have concerns regarding HPV and HSV-1.

1) Are the odds of HPV transmission from the oral cavity to the penis really so low that I can resume unprotected sex with my wife?

2) What are the odds I would not show symptoms for HPV or HSV-1, but still transmit one or the other to my wife during unprotected sex?

3) Can I be tested for HSV-1 now (or within 2 weeks of the encounter) and then again later to see if I caught HSV-1 from this encounter?

4) Is it your expert opinion that I can resume unprotected vaginal and oral sex (fellatio and cunnilingus) with my wife if I don't have any symptoms 5 days (or 10 days) after the encounter?  From the above questions, you can see I am still very concerned about HPV and HSV-1.

All this anxiety over a single encounter of receiving oral sex.

Thank you for this service you are providing.

Edward W. Hook M.D.
Edward W. Hook M.D.
48 months ago

Your continued anxiety in the absence of symptoms following your low risk exposure is disappointing.  Further much of this question is repetitive. 

1.  Oral HIV infections less than half as common (probably closer to 25%) as genital infections and are rarely transmitted by oral sex.  When they occur, they are typically asymptomatic and clear without therapy over time (less than six months).  This is simply not something to worry about and should not keep you from having unprotected sex with your wife; 

2.  No precise quantification is possible but the odds are quite low.

3.  Although we do not recommend it, you could test now to find out if you have HSV-1.  the odds are greater than 50% that you already do.  We recommend strongly about repeat blood tests to diagnose herpes infections.  Even with a prior negative test, false positive tests are more common than acquisition of herpes.

4.  I see no reason for you not to resume unprotected sex with your wife at this time.

This is my third response to your questions.  As explained in our guidelines, following three responses, threads are closed.  there will be no further questions and this thread will be closed tomorrow.  EWH

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48 months ago
Thank you again for your time and the information you provided - I guess I needed to hear it again.  I will take your opinion to heart and begin to move on from this experience.

FYI (for purposes of others reading your most recent response): I believe there is a typographical error.  Specifically, "1. Oral HIV infection" should read "1. Oral HPV infection".

Thank you again for all your help.  It has  been extremely invaluable.